Inspection on 16/01/07 for 147 Cheriton Road

This inspection was carried out on 16th January 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

147 Cheriton Road 10/01/06

147 Cheriton Road 06/07/05

147 Cheriton Road 02/02/05

147 Cheriton Road 02/08/04

147 Cheriton Road 05/01/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 147 Cheriton Road Folkestone Kent CT19 5HE Lead Inspector Geoff Senior Key Unannounced Inspection 16th January 2007 10:00 147 Cheriton Road DS0000023286.V326777.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address 147 Cheriton Road DS0000023286.V326777.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. 147 Cheriton Road DS0000023286.V326777.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 147 Cheriton Road Address Folkestone Kent CT19 5HE Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01303 850475 Nicola.masters@hft.org.uk www.hft.org.uk Home Farm Trust Post Vacant (Ms J. Smith Acting Manager) Care Home 8 Category(ies) of Learning disability (8) registration, with number of places 147 Cheriton Road DS0000023286.V326777.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10th January 2006 Brief Description of the Service: The Home is Registered to accommodate 8 adults with learning disabilities and offers a spacious and comfortable environment to those who wish to develop their daily living and independence skills, the ethos of the Home encourages empowerment of Service Users, assertiveness and maximisation of potential with a view to moving on to a shared flat etc with minimal staff support at a later stage. Current Service Users prefer to be referred to as `Tenants. 147 Cheriton Road, is located on a busy main road running through a pleasant residential area of Folkestone. The Home is close to a mainline rail station and is on a public bus route, it is close to a range of leisure and educational facilities and is within walking distance of the main town shopping area. The premises consist of a large semi detached period property still retaining some original features. The accommodation ranges over four floors with a basement providing space for a laundry facility and additional storage. The kitchen, dining room, and tenants lounge in addition to the staff office/sleep in room and wash facilities are located on the ground floor, with access to the rear garden via the dining area. Tenant bedrooms are located on the first and second floors, and are all single occupancy. Access to these floors is by stairs only, the Home is therefore, unsuitable for anyone with a mobility problem. The Home has been open for approximately 12 years. Tenants are supported by a manager and six care staff, a sleep in staff member is also provided at all times. Outreach is provided by the home to former tenants. 147 Cheriton Road DS0000023286.V326777.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and was undertaken on16/01/07. Time was spent talking with the manager and with staff on duty. The opportunity to discuss with the service users’ their experiences and opinions of the home was limited by their involvement in activities and their inclination to communicate or not. Observations indicated that they were settled in the home, were comfortable in the company of staff and had plenty to do. Throughout the visit, the staff’s attention to the service users’ needs, their patient, friendly and respectful manner and their treatment of each service user as an individual were observed and noted. The premises were viewed and a range of records was inspected. The comments of family members, in phone conversations after the site visit were generally supportive of the service offered. The comments include: “Good homely atmosphere – like a big family” “Nice family atmosphere. Best care she’s ever had” “Home will always accommodate the wishes of the service user if they can” “Staff go the extra mile”. Not all NMS were inspected at this visit. Unless noted, only the core standards were inspected in each outcome group. What the service does well: The home provides a caring and supportive environment for the service users. There is a range of activities available based on the individual and collective needs of the group. These include activities at home, trips out and attendance at education and social facilities. The staff work positively with the service users helping them to communicate their needs and develop skills and confidence. Service users views and opinions are considered. There is good leadership in the home and staff development opportunities within the company to identify and follow further study/training and career paths The home enables service users to maintain appropriate links with families, friends and significant others. 147 Cheriton Road DS0000023286.V326777.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. 147 Cheriton Road DS0000023286.V326777.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection 147 Cheriton Road DS0000023286.V326777.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2&5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users may visit the home and are provided with written information to help them make a decision about moving in. Assessments are undertaken to ensure that the Home can support the service user’s needs and aspirations. Service users are offered a statement of terms and conditions of occupancy. However, amendments are still needed to ensure compliance with the standard. EVIDENCE: The majority of tenant group is long established and there has only been one admission since the last inspection visit. Staff spoken to were able to describe the admission process and emphasised the importance of ensuring that the tenant’s needs are fully assessed and can be appropriately supported by the home. Admissions, even if they are known to the service, are subject to a protracted introduction and assessment period. Prospective service users are encouraged to visit the home prior to admission and may use the opportunity to meet and spend time with the existing service users and staff, view the accommodation and find out about the routine and lifestyle they could expect to experience at 147. Assessments, undertaken prior to, and subsequent to, 147 Cheriton Road DS0000023286.V326777.R01.S.doc Version 5.2 Page 9 admission contribute to the care planning process. Input is welcomed from the service users and families and from relevant agencies and professionals. Aspirations may be expressed and, where possible/ achievable, appropriate support is planned. The home is still to address an outstanding recommendation to amend tenant contracts in compliance with standard 5.2. 147 Cheriton Road DS0000023286.V326777.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9. Quality in this outcome area is good, This judgement has been made using available evidence including a visit to this service. The care planning system is clear, consistent and provides staff with information and guidance when supporting residents. Individual goals are identified and considered within the planning and risk assessment process. Service users are encouraged to have their say in the decision making process. EVIDENCE: Person centred planning documentation was viewed at this inspection. The content and detail of information provided within the person centred plans, informs and enables new and existing staff to better understand and support the needs of tenants effectively, and help them with working towards achieving goals. Information about individuals is available to all staff and is indexed for ease of reference. Day records note the completion or otherwise of support tasks identified in care plans and may be easily cross-referenced. Service users were observed interacting comfortably with staff on matters relating to their 147 Cheriton Road DS0000023286.V326777.R01.S.doc Version 5.2 Page 11 general activity and health care. Staff were positive and supportive in response. The home operates a key worker system that aims to be supportive but not exclusive. Individual’s affiliation, gender, experience and level of expertise is acknowledged and considered within the system. Service users may express their ideas and concerns individually or as a group at the regularly held house meetings. Risks are viewed positively by the home and assessments are undertaken in order that service users can participate in activities with the appropriate level of support and supervision or are helped to understand why limitations may be placed on their lifestyle. 147 Cheriton Road DS0000023286.V326777.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17. Quality in this outcome area is good, This judgement has been made using available evidence including a visit to this service. Tenants are supported and facilitated to maintain contact with families and friends. . Tenants enjoy an active, fulfilling daily lifestyle that respects their rights. Tenants actively participate in the development of menus and the preparation and cooking of meals. EVIDENCE: Feedback from relatives and tenants indicate that regular contacts are encouraged and maintained. Tenants confirmed visits home for Christmas, family holidays and special occasions, staff may support and facilitate contacts by helping with letter writing and e-mailing and in some instances transportation to ensure contacts are maintained. Visiting arrangements to the house are flexible. 147 Cheriton Road DS0000023286.V326777.R01.S.doc Version 5.2 Page 13 Discussion with staff and tenants confirmed tenants have responsibility for their own personal effects and have lockable facilities in their rooms to which they have keys. They also have their own room keys and are responsible for locking their bedrooms. Staff were observed throughout the inspection interacting with tenants and participating in supervised activities in house, e.g. supporting letter writing activities, cooking. Other tenants were observed occupying their own time with drawing etc. All tenants have housekeeping responsibilities. Staff in the home have worked positively with the service users to establish interests, likes and dislikes. They are supported by the organisation to provide a wide range of formal and informal activities. The staff reported that the tenants utilise the courses at the local college and use resources in the community for social events. Tenants may also pursue voluntary and paid employment opportunities in the local area. One works at a local supermarket whilst others help out at a nursery and the Salvation Army Centre. Tenants were supported, in small groups, to holiday, at their own expense, at holiday camps of their choice. 147 Cheriton Road DS0000023286.V326777.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are treated with respect for their dignity and privacy. Healthcare needs are assessed, monitored and addressed. Medication management systems appear to be adequate. and safe. It was recommended however that competency assessments are undertaken and recorded for all staff likely to be involved in the management of medication. EVIDENCE: Service users are encouraged to do as much as possible for themselves in order to maintain their dignity, independence and control over their lives. Staff are on hand to help when needed and offer guidance where appropriate. The personal support needs of the service users are well documented in their case files. Assistance and support in matters relating to personal hygiene and appearance is only offered when required. The staff were observed responding to service users in a friendly and non patronising manner. Records indicate that the healthcare needs of the service users are monitored and addressed It was reported that the home has developed positive relationships with local healthcare agencies. Notes seen on one file indicated a 147 Cheriton Road DS0000023286.V326777.R01.S.doc Version 5.2 Page 15 constructive liaison with appropriate professionals for advice an guidance in managing behavioural issues. Medication records and storage arrangements were viewed and appeared to be adequate for the needs of the home. It was reported that staff are provided with appropriate training. In the absence of written evidence it was recommended that competency assessments are undertaken and recorded for all staff likely to be involved in the management of medication. 147 Cheriton Road DS0000023286.V326777.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff receive training in the protection of vulnerable people. There are systems in place for the expression and resolution of concerns or complaints. EVIDENCE: Staff spoken to indicated an understanding of issues relating to the protection of vulnerable people and are aware of their role, to ensure people living in the home are protected from abuse in all its forms and that they are the service users main key to having their views heard. The Manager confirmed that adult protection training is offered by the Organisation. In conversation with tenants and family members it was apparent that they would happily approach staff and management if they had any concerns or complaints. 147 Cheriton Road DS0000023286.V326777.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24,30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The service provides a homely and comfortable environment in which to live and work. Everyone accommodated in the home has his or her own bedroom There are sufficient toilets and bathrooms to meet the presenting needs of all the residents. The Acting manager agreed however that the surface temperature of the radiators were so high as to present a possible risk. She confirmed that she would seek advice and take appropriate action without delay. EVIDENCE: The décor and furnishings in the communal areas provide a comfortable and welcoming environment. The service users’ own rooms are decorated and arranged to reflect their choice, interests, character and personality. 147 Cheriton Road DS0000023286.V326777.R01.S.doc Version 5.2 Page 18 Bathrooms and toilets are appropriately placed to provide reasonable access to all the service users in relation to the location of their individual rooms. The Manager indicated that health and safety aspects of the building were given regular attention by the organisation’s own maintenance team. The hot water outlets are reportedly governed by thermostatic controls. The Acting manager agreed however that the surface temperature of the radiators were so high as to present a possible risk. She confirmed that she would seek advice and take appropriate action without delay. 147 Cheriton Road DS0000023286.V326777.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home endeavours to ensure that the staff are appropriately trained to fulfil their roles and responsibilities. competent and The home safeguards the service users’ welfare with appropriate procedures and policies on the selection and recruitment of appropriate staff. The home conducts good support and supervision networks for the care staff. EVIDENCE: The home has a training programme for the care staff that not only considers the statutory obligations for each staff member, but also enables staff to undertake training in areas that relate to the different presenting needs of the service users. Staff spoken to indicated a clear understanding of the aims of the home and the value of clear and accurate communication. The staff skill mix and their ability to interact with each other was seen by the inspector whilst observing aspects of the delivery of care to the service users. The home conducts good support and supervision networks for the care staff. One to one supervision is available on a regular basis. 147 Cheriton Road DS0000023286.V326777.R01.S.doc Version 5.2 Page 20 Staff files seen indicated that appropriate checks are undertaken on prospective staff prior to appointment and commencement of duties. New staff are expected to complete, within the probationary period, LDAF based induction and foundation training. There is a blend of youth and experience in the team of 4 full time and one 30hr per week support workers plus two relief staff who cover any shortages. One of the full time staff works a rota that offers 1-1 support exclusively for one tenant during the day. It was reported that the staff rota pattern has been altered to address the number and gender recommendations noted in the last inspection report. 147 Cheriton Road DS0000023286.V326777.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Although there is currently no Registered manager the home appears to be well managed and run in the best interests of the service users. There is a good level of consultation with service users, families and staff. EVIDENCE: The home does not currently have a Registered Manager. The Acting Manager is however an experienced individual having worked at the Home for a number of years She presented as knowledgeable and enthusiastic and is keen to maintain a proactive and efficient service. There were a number of comments from tenants’ family members in praise of the staff team as a whole and the manager in particular, in fostering an open and inclusive ethos enabling everyone to have his or her say. 147 Cheriton Road DS0000023286.V326777.R01.S.doc Version 5.2 Page 22 Feedback is welcomed via staff/ tenant meetings and contact with families. A representative of the organisation conducts Reg. 26 visits each month. 147 Cheriton Road DS0000023286.V326777.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 x 2 3 3 x 4 x 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 x 26 x 27 x 28 x 29 x 30 2 STAFFING Standard No Score 31 x 32 3 33 x 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x 3 x 3 x x 3 x 147 Cheriton Road DS0000023286.V326777.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA6 Regulation 15 Requirement Tenants or their representatives where necessary to sign their agreement to the PCP/care plan (previous requirement partially addressed within timescale). Timescale for action 30/03/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard YA24 YA20 .6 (iii) Good Practice Recommendations The Manager seek advice and take appropriate action regarding the radiator surface temperatures. Medication training programme to include a formal assessment of the carer’s competence to safely administer medications. That 5.2iii & 5.2vii of the standard are incorporated in with the licence agreement for all tenants at Cheriton road 3. 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